Maurice Blackburn welcomes Victorian Ombudsman’s investigation into handing of workers compensation claims

6 November 2015
Maurice Blackburn has welcomed a decision by the Victorian Ombudsman to launch an ‘own motion’ investigation into the management of workers compensation claims.

Principal at Maurice Blackburn Liberty Sanger, a workplace injury specialist, said the announcement by Ombudsman Deborah Glass was significant considering it was the second own motion Ombudsman’s  investigation in five years into WorkSafe, their insurers and the handling of workers' compensation claims.

“We receive many complaints from our clients about the way they have been treated and the way their claims are considered by WorkSafe agents,” Ms Sanger said.

“Many complaints relate to the manner in which their workers' compensation claims are considered, which can lead to their injuries worsening rather than helping with their rehabilitation and return to work.

“Many medical practitioners are also frustrated with their interactions with WorkSafe agents in having their medical opinions second-guessed, or forcing them to wait lengthy periods for approvals for patients to get necessary treatment. This can also lead to a worsening of workers’ injuries and affect their prospects of successful rehabilitation and return to work.

“In May 2011 the then Ombudsman initiated an own motion investigation on the back of rising complaints from workers (246 in 2007-08 and 312 in 2009-10). It would seem that despite the recommendations that were made, complaints to the Ombudsman’s office have continued to rise (370 in 2014-15), as have the number of disputes lodged with the Accident Compensation Conciliation Service.”

“The fact that this is the second own motion investigation in five years suggests that the way in which WorkSafe and its insurers treat injured workers and their medical practitioners needs a complete re-think. People should not be treated as second class citizens or be suspected of fraud just because they have been injured at work.”

“We are also interested to see what the investigation reveals about incentives offered by WorkSafe to insurers and whether they have played any role regarding insurers denying workers claims.”

CGU was fined $2.8 million dollars in 2011 for manipulating its compliance with an incentive offered by WorkSafe as a result of the last Ombudsman investigation, she said.

“While we hope that insurers have learned their lesson, we note that the Ombudsman is again investigating what role financial incentives have played in decisions to deny or terminate workers compensation entitlements. It’s not good for workers, employers or WorkSafe if incentives encourage insurers to reject claims and force workers into costly litigation. 

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